Usefulness of Simulation Based Learning in First Year Medical Students: A Quasi-experimental Study

Abstract

Introduction: Auscultation of chest is an important part of clinical patient assessment and the skills required to interpret it are traditionally learned by listening the heart and lung sounds of many different patients. It may be difficult for the students to compare actual heart and lung sounds with similar findings. Therefore, use of simulated heart and lung sounds in teaching and training of medical students may be helpful in such scenario as it allows the repetitive and individualized oriented training in support of learning in real scenarios. Aim: To evaluate the usefulness of simulation in understanding various respiratory and cardiovascular sounds, to assess the learning gain of students by pretest and post-test and to evaluate the perception of students towards simulation based learning. Materials and Methods: The present quasi-experimental study was carried out on 100 first year MBBS students at Clinical Skills Laboratory and Department of Physiology, at Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India, from April 2018 to September 2018. Pretest was taken before intervention from all participants. Students were randomly divided into two groups. Group I had undergone clinical examination of Cardiovascular System (CVS) and Respiratory System (RS), where as, group II had undergone clinical examination of CVS and RS as well simulation based learning. Objective Structured Clinical Examination (OSCE), post-test and feedback was obtained from all participants. Data was analysed using Microsoft excel and Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: Both groups had 50 subjects each,with age group of 18-20 years and mean age 18.3±1.9 years . There were 21 male and 29 female subjects in both groups. Mean scores of OSCE in group I and II were 7 and 8.18 respectively. Mean score of pretest in group I and II were 5.04 and 5.02 respectively, whereas mean score of post-test in group I and II were 6.66 and 7.54 respectively. Comparison of OSCE and post-test scores in two groups was found to be statistically significant (p-value <0.0001). Conclusion: Understanding of cardiovascular and respiratory sounds was better in group II where simulation based learning was used compared to other group. Hence, it was concluded that simulation based learning is useful additional tool to learn clinical examination of cardiovascular and respiratory physiology. It helps first MBBS students to enhance their clinical knowledge, skills and attitude.